Tuesday, October 09, 2007

Caregiving: stay involved

Last Wednesday was the most recent Care Plan Review. Required under the Nursing Home Reform Act of 1987 (OBRA 87), Care Plan Reviews are regularly scheduled opportunities for the patient, family and/or designated medical advocate to sit down with care facility department heads and talk about a patient’s care plan.


Surrounded with nursing and medical records, dietician, physical therapist, activity/recreation coordinator, and custodial care staff feels like being at a board meeting.


Periodically I like to include Patti. She has a way of interjecting ‘her’ perspective. For example when asked once if she had any questions she responded, “What the (bleep) are you people talking about, I just want a (bleeping) cigarette!” <grin>


For a decade and a half I had only discussed caregiving between myself and Patti. With years of Pattis progressing cognitive impairment from Multiple Sclerosis basically those conversations had dwindled to talking with myself. <grin> The care facility era introduced team work.


Whereas I was Patti’s sole caregiver 24 hrs a day, 7 days a week; now at least 21 staff on her unit each day (7 per shift X 3 shifts) interact with and care for Patti, in part, each and every day. 21 vs 1! You can believe that besides being ‘better’ it takes communication and ‘written’ communication.


Home caregivers make it up as they go along, as I did for 15 years. Always inventing care approaches as needed and more often than not learning through trial and error. The care facility era in contrast is about team work.


It does take adjustment and effort for a home caregiver to ‘stay involved’ especially since most likely you have reached this point because of overwhelming care needs and caregiver exhaustion. It may seem like you are on another planet.


Just remember YOU know the patient best. Don’t be intimidated, after all YOU have been doing the work of a team by yourself for years. YOU have more ‘real life’ credentials than anyone to sit at that meeting.


Caregivingly Yours, Patrick Leer




  1. ((((((((((((((((HUGSTOYOU)))))))))))))))))))))))You do so much for Patti,I know she loves you for it.I admire you for that.Have a nice night.

  2. very well said!! when i worked at the nursing home it amazed me how many had family who would never show up. then we had the ones who were there everyday.


  3. Sounds very similar to an IEP meeting to me. However, I have never had any of the kids express their desire for a cigarette <grin>.... I always enjoy hearing Patti's opinion. She pretty much nails it, doesn't she??  


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